Graduate Medical Education

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    Glomus tumor: A rare differential diagnosis for subungual lesions
    (2024-09) Alnajjar, Anas
    Glomus tumors are rare, benign vascular hamartomas of the glomus apparatus with unknown etiology. They can arise from anywhere in the body. However, up to 90% of them are located in the subungual region of the fingers, as in the case of our patient. These tumors typically present with the classic triad of pain, cold sensitivity, and point tenderness. Characteristic US and MRI findings aid the clinical diagnosis; nevertheless, a histopathologic examination is confirmatory. There is a well-documented mean delay in diagnosis of around 7 years, due to the rarity, benignity, small size, and lack of proper knowledge about the condition. However, we reported a case with a delay in diagnosis that reached 40 years, which is much longer than what is documented in the literature. A high index of suspicion is required for early diagnosis and management of glomus tumors to relieve the patient's long-term suffering and prevent possible secondary nail deformities. The curative treatment of glomus tumor is complete surgical excision, which is crucial to prevent recurrence and relieve the patient's symptoms.
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    Occurrence of Femoral Nerve Palsy After Total Hip Arthroplasty (THA) Using the Direct Lateral Approach.
    (2024-11) Nached, Yasmin; Al-Rawi, Zeinab; Abdelwahab, Abdulla; Elsayed, Ahmed; Ismaeil, Ali H
    Femoral nerve palsy (FNP) is a rare but serious complication after total hip replacement (THP). Despite its rarity, FNP can significantly impact patient recovery and quality of life. This case report examines the occurrence of FNP in a patient following a primary THP and highlights the importance of surgical technique and postoperative detection and its management. We present the case of a 38-year-old male with a history of microscopic polyangiitis on long-term steroid treatment, who developed FNP following THP. The patient was admitted with non-traumatic right hip pain with osteoporotic fracture of the femoral head and underwent elective THP. Postoperatively, the patient showed quadriceps weakness and related sensory deficits. Postoperative assessments included physical examination, electromyography (EMG), nerve conduction studies (NCS), and magnetic resonance imaging to assess the extent of the nerve injury. EMG and NCS confirmed severe femoral mononeuropathy with profound active denervation changes. A subsequent magnetic resonance imaging revealed atrophy of the right sartorius and quadriceps femoris muscles. Conservative management was decided, including physiotherapy and close follow-up, which led to significant gradual improvement over six months, with enhanced knee range of motion (ROM), increased quadriceps strength, and improved sensation on the medial side of the leg and foot. Femoral nerve injuries, although uncommon, pose significant risks in THP. Excessive retraction during surgery may contribute to these injuries. Early diagnosis, conservative management, and interdisciplinary coordination are crucial to achieve optimal recovery.
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    The need for implementing a standardized, evidence-based emergency department discharge plan for optimizing adult asthma patient outcomes in the UAE, expert meeting report.
    (2024-11-06) Buhumaid, Rasha; Mahboub, Bassam; Iqbal, Mohammed Nizam
    Background: Asthma is a common chronic respiratory inflammatory disease that adversely affects patients' quality of life (QoL) and overall well-being. When asthma is not adequately controlled, there is a higher risk of exacerbations and hospitalizations, thereby increasing the direct and indirect costs associated with the treatment and productivity loss. Overreliance on SABA and underutilization of ICS in the management of asthma can result in suboptimal treatment and poor asthma control. Patients who visit the emergency department are more likely to have poorly controlled asthma. Ensuring that these patients are provided with an evidence-based treatment plan during discharge can help reduce the risk of future exacerbations and consequently reduce the burden on the UAE healthcare system.
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    Publication
    The need for implementing a standardized, evidence-based emergency department discharge plan for optimizing adult asthma patient outcomes in the UAE, expert meeting report.
    (2024-11-06) Buhumaid, Rasha
    Asthma is a common chronic respiratory inflammatory disease that adversely affects patients' quality of life (QoL) and overall well-being. When asthma is not adequately controlled, there is a higher risk of exacerbations and hospitalizations, thereby increasing the direct and indirect costs associated with the treatment and productivity loss. Overreliance on SABA and underutilization of ICS in the management of asthma can result in suboptimal treatment and poor asthma control. Patients who visit the emergency department are more likely to have poorly controlled asthma. Ensuring that these patients are provided with an evidence-based treatment plan during discharge can help reduce the risk of future exacerbations and consequently reduce the burden on the UAE healthcare system.